Organization Active NPI

Laurel Oak Alf, Inc.

  • Assisted Living Facility
  • Jacksonville, FL
National Provider Identifier
1285077214
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL10423 Issued in FL
Legal business name
LAUREL OAK ALF, INC.
Practice address
3809 Capper Rd
Jacksonville, FL 32218-4525
Phone
(904) 765-5227
Fax
(904) 765-5228
NPI assigned
Apr 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Antonio M Doctor
Title
Owner/Administrator
Phone
(904) 765-5227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL10423 FL Primary

Addresses

Primary practice location

3809 Capper Rd
Jacksonville, FL 32218-4525

Mailing address

3809 Capper Rd
Jacksonville, FL 32218-4525
Phone (904) 765-5227

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1285077214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3809 CAPPER RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184525",
            "telephone_number": "904-765-5227",
            "fax_number": "904-765-5228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3809 CAPPER RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184525",
            "telephone_number": "904-765-5227",
            "fax_number": "904-765-5228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL OAK ALF, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "DOCTOR",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "904-765-5227",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL10423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.